Physicians discuss possible causes of RSV surge

Nov. 11—ANDERSON — COVID-19 restrictions were not without consequence. A surge in cases of Respiratory Syncytial Virus Infection, or RSV, are being seen across the country and could strain hospitals once again.

Madison County healthcare officials are reporting an increase in cases, but hospitals are not overwhelmed.

Melinda Smith, a nurse practitioner for Ascension St. Vincent and Thomas Short, an M.D. from the emergency medicine department at Community Hospital Anderson both reported an uptick in cases.

Short said cases requiring hospitalization are referred to Riley Hospital for Children or Peyton Manning Children's Hospital.

Typically, every child under age 2 will catch RSV, however, COVID restrictions limited opportunities for exposure, said Dr. Christopher Belcher, pediatric infectious disease physician for Peyton Manning Children's Hospital at Ascension St. Vincent.

"Those kids never caught it and they got older and they became 3- and 4-year-olds. Now at this point, you have all these 1- and 2-year-olds who've never had RSV, in addition to a bunch of 3- and 4-year-olds who never did. So the virus has a lot of new kids it can infect who've never had it before," he said.

Weather changes were mentioned as another possibility. December through February, he said, is when the virus most often occurs. However, there have been cases in summer and fall. It is unknown exactly when these respiratory disease will arrive, as it was with COVID.

RSV can lead to additional infections, which can be severe. According to Belcher, diseases like pneumonia, croup and bronchiolitis can be caused by RSV.

Bronchiolitis differs from bronchitis in that it typically affects children and infants, instead of adults.

Belcher said common symptoms of RSV are runny nose, stuffy nose, sore throat and low grade fever.

Home care could include the use of a cool mist humidifier and/or a nasal aspirator. Both could help kids breathe better.

RSV is common and most recover within one to two weeks, according to the U.S. Centers for Disease Control and Prevention, though some cases may be more severe.

Symptoms such as hard and/or fast breathing, changes in lip color or continued trouble breathing after treatment could be cause for concern, Belcher said.

Parents should consider taking their child to the emergency room if changes in lip color or severe trouble breathing occur, he said.

Premature babies and those with heart or lung disease could be at risk for severe illness.

Such children could receive monthly injections of palivizumab, which could prevent hospitalization. Whether it could be used for children without those risk factors, he said, is unknown.

Masking, handwashing, and sanitizing were recommended by Belcher as preventative measures. Instead of droplets, RSV is mostly transmitted via touch.

Smith added avoiding large crowds and staying home, if running a fever to the list.

COVID and flu vaccinations are also recommended to prevent strain on hospitals, he said. No vaccine for RSV is currently available, he said.

Pfizer announced an RSV vaccine they believe is 82% effective in reducing hospitalizations for infants under three months old and 69% of those under six months, according to a recent New York Times article.

GlaxoSmithKline (GSK), a pharmaceutical company from the United Kingdom reported their vaccine had an overall efficacy rate of 83%.

The article said the U.S. Food and Drug Administration is expected to begin its review of GSK's vaccine by the end of this year.

Smith said a monoclonal antibody treatment has been approved in Europe. Beyfortus as its called, was approved by the European Union for prevention in newborns and infants, a Nov. 4 press release from Astra Zeneca said.

Unlike the current treatment, it does not have to be limited to those most vulnerable. One dose of the antibodies reduced the number of lower respiratory tract infections by 74.5% over the course of a typical RSV season.

According to the Mayo Clinic, monoclonal antibodies are engineered antibodies that work with the body's immune system to fight off a disease.

Those with concerns should notify their doctor or consult Kidshealth.com, which Smith recommended as a credible resource.

Follow Caleb Amick on Twitter @AmickCaleb. Contact him at caleb.amick@heraldbulletin.com or 765-648-4254.